Vertical Scar for a Skin-Only Tummy Tuck?

had a tummy tuck 2 weeks ago(skin-only) At post-op appt,I noticed that standing up I had a flat stomach with a little pooching around belly button, but what bothers me is when i bend over& sit down; I have a little roll on each side of my belly button. When I asked my surgeon he said some people's skin looses elasticity and re-strech in 48 hrs,especially w/ massive weight loss(185lbs). he said that he would have to do a vertical scar from tummy tuck line vertically to my breasts. why this?

Doctor Answers 6

Tummy tuck scars

If this is a postop photo, you do have some extra skin still.  Patients with massive weight loss have extremely poor elasticity and sometimes it is necessary to have a full vertical scar also to take out as much as possible.  It will never be "tight" though!

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Loose skin above belly button after abdominoplasty

You do have some options for this problem if it does not improve after 3 months (give it some time for the swelling to improve and skin to contract). It is common for patients who lost a large amount of weight to have the skin stretch out a bit after surgery. If you don't see improvement, the following options can be discussed with your Board Certified plastic surgeon:


• Repeat or circumferential abdominoplasty
• Vertical skin excision (as was recommended)
• Reverse abdominoplasty (skin being pulled up through an incision in the breast crease)
 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
5.0 out of 5 stars 27 reviews

A Panniculectomy (Skin ONLY removal) is NOT a Tummy Tuck and will not produce Tummy Tuck Results

Regarding: "Vertical Scar for a Skin-Only Tummy Tuck?

had a tummy tuck 2 weeks ago(skin-only) At post-op appt,I noticed that standing up I had a flat stomach with a little pooching around belly button, but what bothers me is when i bend over& sit down; I have a little roll on each side of my belly button. When I asked my surgeon he said some people's skin looses elasticity and re-strech in 48 hrs,especially w/ massive weight loss(185lbs). he said that he would have to do a vertical scar from tummy tuck line vertically to my breasts. why this
?"

A Skin only abdominal wall resection is called a PANNICULECTOMY or apron resection. It removed the overhand WITHOUT tightening the tummy muscles, without lifting the entire tummy skin up to the ribs to get off all skin excess and without upward movement of the belly button.

The average baby weighs close to 7 pounds and yet - by distending the womb from its normal lime size to that of a summer watermelon, it PERMANENTLY stretches the tummy muscles as well as splits the 6 pack (rectus) muscles. When you gained close to 200 pounds, a good portion of the fat was INSIDE the belly and was not all limited to fat under the skin. As a result, morbidly obese people have the same or worse stretching of the abdominal wall muscles as do pregnant women. To get pleasing results, they must be operated with similar muscle tightening techniques.

THE PROBLEM is that having a tight, flat tummy is NOT a medical NEED. It is a purely cosmetic need which insurance companies do NOT pay for. If you want the full "package" - a flat tummy, narrow waist, lifted Mons pubis etc - you must pay for it out of your pocket.

Since having a skin overhang is associated with a hard to clean area with bacterial overgrowth, rashes and sometimes ulcers, SOME insurance companies MAY pay for removal of this overhang with a PANNICULECTOMY. The operation is far simpler and shorter than a tummy tuck BUT patients often mistake it with a real tummy tuck. It is not and the much poorer results bear this out.

By the way, I have done hundreds of these operations and have NEVER encountered "some people's skin looses elasticity and re-stretch in 48 hrs". It is true that stretch mark damaged skin will stretch eventually but it never happens in 2 days. I suspect you had a limited operation and as a result have a limited result.

You MAY wish to obtain a second opinion with the operative note of your procedure. I would wait 6-8 months before having further surgery on this area to allow the inflammation to subside and skin return to normal.

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 73 reviews

Skin laxity after tummy tuck

With massive weight loss I often do what is called a fleur-de-lis approach imcorporating a vertical incision in some patients because as the weight comes down and you "deflate" it comes off in a verical and horizontal way, and a standard tummy tuck is often not enough.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Persistent skin redundancy following tummy tuck for massive wieght loss.

IT is very true that patients with massive weight loss, do not have good skin elasticity and have a greater tendency for recurrent skin laxity following body contouring procedures. Another alternative to performing a veritcal for upper abdominal laxity is to cosider a possible reverse abdominoplasty.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 56 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.